| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0466 |
Home vent non-invasive inter |
186 |
123 |
$31K |
| E1390 |
Oxygen concentrator |
1,579 |
997 |
$29K |
| E0465 |
Home vent invasive interface |
53 |
37 |
$18K |
| E0439 |
Stationary liquid 02 |
160 |
136 |
$12K |
| A7526 |
Tracheostomy tube collar |
116 |
75 |
$6K |
| A4624 |
Tracheal suction tube |
114 |
83 |
$4K |
| K0738 |
Portable gas oxygen system |
606 |
367 |
$3K |
| E0601 |
Cont airway pressure device |
326 |
221 |
$2K |
| A7030 |
Cpap full face mask |
135 |
75 |
$2K |
| A7507 |
Integrated filter & holder |
50 |
25 |
$2K |
| A7034 |
Nasal application device |
191 |
103 |
$2K |
| E0434 |
Portable liquid 02 |
251 |
190 |
$2K |
| A7000 |
Disposable canister for pump |
148 |
97 |
$1K |
| A7031 |
Replacement facemask interfa |
103 |
59 |
$1K |
| E0600 |
Suction pump portab hom modl |
53 |
39 |
$1K |
| E0431 |
Portable gaseous 02 |
206 |
140 |
$909.62 |
| A7038 |
Pos airway pressure filter |
355 |
188 |
$785.44 |
| A7035 |
Pos airway press headgear |
222 |
119 |
$749.85 |
| A7037 |
Pos airway pressure tubing |
257 |
138 |
$729.38 |
| A7520 |
Trach/laryn tube non-cuffed |
18 |
13 |
$696.08 |
| A7046 |
Repl water chamber, pap dev |
139 |
68 |
$625.35 |
| E1392 |
Portable oxygen concentrator |
134 |
78 |
$322.76 |
| A4604 |
Tubing with heating element |
34 |
15 |
$296.63 |
| A7003 |
Nebulizer administration set |
49 |
40 |
$154.24 |
| E0562 |
Humidifier heated used w pap |
50 |
38 |
$150.05 |
| A7525 |
Tracheostomy mask |
93 |
54 |
$114.83 |
| A7039 |
Filter, non disposable w pap |
21 |
12 |
$35.83 |